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Ahlström MG, Feldt-Rasmussen B, Legarth R, et al. Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study. Clin Epidemiol. 2015;7:391-9doi: 10.2147/CLEP.S83530.
Ahlström, M. G., Feldt-Rasmussen, B., Legarth, R., Kronborg, G., Pedersen, C., Larsen, C. S., Gerstoft, J., & Obel, N. (2015). Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study. Clinical epidemiology, 7391-9. https://doi.org/10.2147/CLEP.S83530
Ahlström, Magnus Glindvad, et al. "Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study." Clinical epidemiology vol. 7 (2015): 391-9. doi: https://doi.org/10.2147/CLEP.S83530
Ahlström MG, Feldt-Rasmussen B, Legarth R, Kronborg G, Pedersen C, Larsen CS, Gerstoft J, Obel N. Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study. Clin Epidemiol. 2015 Aug 28;7:391-9. doi: 10.2147/CLEP.S83530. eCollection 2015. PMID: 26357490; PMCID: PMC4559253.
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Clin Epidemiol. 2015 Aug 28;7:391-9. doi: 10.2147/CLEP.S83530. eCollection 2015.

Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study.

Clinical epidemiology

Magnus Glindvad Ahlström, Bo Feldt-Rasmussen, Rebecca Legarth, Gitte Kronborg, Court Pedersen, Carsten Schade Larsen, Jan Gerstoft, Niels Obel

Affiliations

  1. Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  2. Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  3. Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
  4. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
  5. Department of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus, Denmark.

PMID: 26357490 PMCID: PMC4559253 DOI: 10.2147/CLEP.S83530

Abstract

INTRODUCTION: Smoking is a main risk factor for morbidity and mortality in people living with human immunodeficiency virus (PLHIV), but its potential association with renal impairment remains to be established.

METHODS: We did a nationwide population-based cohort study in Danish PLHIV to evaluate the association between smoking status and 1) overall renal function and risk of chronic kidney disease (CKD), 2) risk of any renal replacement therapy (aRRT), and 3) mortality following aRRT. We calculated estimated creatinine clearance using the Cockcroft-Gault equation (CG-CrCl), and evaluated renal function graphically. We calculated cumulative incidence of CKD (defined as two consecutive CG-CrCls of ≤60 mL/min, ≥3 months apart) and aRRT and used Cox regression models to calculate incidence rate ratios (IRRs) for risk of CKD, aRRT, and mortality rate ratios (MRRs) following aRRT.

RESULTS: From the Danish HIV Cohort Study, we identified 1,475 never smokers, 768 previous smokers, and 2,272 current smokers. During study period, we observed no association of smoking status with overall renal function. Previous and current smoking was not associated with increased risk of CKD (adjusted IRR: 1.1, 95% confidence interval [CI]: 0.7-1.7; adjusted IRR: 1.3, 95% CI: 0.9-1.8) or aRRT (adjusted IRR: 0.8, 95% CI: 0.4-1.7; adjusted IRR: 0.9, 95% CI: 0.5-1.7). Mortality following aRRT was high in PLHIV and increased in smokers vs never smokers (adjusted MRR: 3.8, 95% CI: 1.3-11.2).

CONCLUSION: In Danish PLHIV, we observed no strong association between smoking status and renal function, risk of CKD, or risk of aRRT, but mortality was increased in smokers following aRRT.

Keywords: chronic kidney disease; creatinine clearance; incidence rate ratio; mortality; mortality rate ratio; renal replacement therapy

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